|William Harvey (1578-1657) has been described as the leading medical scientist of the Seventeenth Century and the founder of modern physiology. He is credited with being the first man to correctly describe the human blood circulation system. This system was first detailed in his Exercitatio anatomica de motu cordis et sanguinis in animalibus (Concerning the motion of the heart and blood), more commonly referred to as De motu cordis. This slim but significant volume is from the collection of William Hunter (1718-83); it has been selected as our Book of the Month for June to celebrate the 200th anniversary of Hunter's collections being gifted to Glasgow University.|
||The discovery and description of the blood circulation system was a landmark in medical history; it has even been described, by historian K. F. Russell, as the "greatest single contribution to anatomy and medicine in any century". In his short 72 page essay, Harvey attempted to describe the motion of both the heart and the blood, proving his hypothesis scientifically using empirical observations and reasoning. Indeed, the way in which Harvey tested his ideas and accumulated quantitative data to support his findings was arguably just as important to the development of medicine and science as the discovery itself.|
|By using simple, clear and easily replicable experiments Harvey described the two phases of the heart's motion: systole (contraction) and diastole (expansion). Subsequently, by estimating the volume of blood in the left ventricle of the heart and measuring the rate at which it flowed into the principal artery, Harvey concluded that existing explanations of blood movement must be incorrect. Contemporary thought posited that blood was created in the liver before passing through the heart and being consumed by the body. Harvey's measurements suggested that the rate at which blood was being pumped out of the heart would necessitate an impossibly large volume of blood to begin with for traditional models to be correct. Observations of the heart's one-way valve system and an appreciation of cycles in nature instilled through his Aristotelian education helped Harvey to conceive of the circulation system.|
|Ever since De motu cordis
was first published in 1628, a number of competing claimants,
in opposition to Harvey, have been promoted as the true
"discoverers" of circulation. While most of these
figures have been dismissed by commentators and historians, one
possibility, Ibn an-Nafis, seems to have merit. Nafis, an
Arabian physician who studied in Damascus and taught in Cairo,
apparently described pulmonary circulation in the Thirteenth
Century - almost three hundred years before Harvey.
Unfortunately for him, his work seems to have been unknown
outside of the eastern Mediterranean: he is therefore not widely
acknowledged as the "discoverer" of circulation since his work
failed to impact on the development of western medicine.
Nontheless, despite Nafis not directly impacting on Harvey's work, the improved understanding of the circulation system, as with any scientific "discovery", arrived as a result of earlier breakthroughs. A new body of anatomical knowledge began to emerge from the mid Sixteenth Century onwards. Firstly in 1543 Andreas Vesalius (1514-1564), professor of surgery and anatomy at Padua, published De humani corporis fabrica, accurately describing human anatomy for the first time. Matteo Realdo Colombo (1516-1559) and then Girolamo Fabrizi of Aquapendente (Fabricius) (ca. 1533-1619), William Harvey's tutor, added to the body of physiological and anatomical knowledge by deducing that, contrary to received opinion, only one blood circulation system existed rather than the two proposed by Galen (129- ca. 200).
||Prior to Vesalius, Galenic orthodoxy had gone unchallenged for
centuries. Galen and his adherents were unable to
dissect human bodies on religious and ethical grounds, instead
having to study other mammals. Consequently, many mistakes and
false assumptions crept into anatomical discourse. By the
Sixteenth Century, Galenic ideas of anatomy and physiology were
taught in universities alongside an Aristotelian natural
philosophy that linked all natural structures directly with the
function for which they were intended.
Galen proposed a method of study that allied reason and logic
with sensory observations. He suggested that both reason and
observation served a dual purpose: arriving at the truth - then
helping confirm truths once they became established. Despite being
wrong in many of his conclusions, the anatomical structures
described by Galen fitted perfectly with the function for which he
claimed they were intended. Considering that approved methodology
advocated investigations to support established "truth" rather
than test it, no significant medical breakthroughs were achieved
for nearly 1500 years after Galen's death.
||Vesalius corrected many anatomical myths with his 1543
De humani corporis fabrica; however, Galen's theories on physiology
were still popular at the start of the Seventeenth Century. Many
of these ideas seem strange in our post-Harveian world where the
heart is acknowledged as merely a pump for the blood.
Harvey's contemporaries understood the body in the same way that Aristotle and the hippocratics had described it - as a microcosm of the greater cosmos. The four earthly elements of fire, earth, water and air were apparently manifested in the human body in four humours: yellow bile, black bile, blood, and phlegm. Each of these humours had specific character traits: yellow bile - choleric and hot tempered; black bile - melancholic and sad; blood - sanguine and cheery; and phlegm - phlegmatic and unemotional.
As opposed to modern ideas of disease concentrating on external factors, the humoural system associated any health problems with a loss of humoural equilibrium within the body. Personality and behaviour, now associated with mental processes and brain function, were directly related to physiological processes of the heart and the balance of humours. The heart therefore was right at the centre of what it was to be human.
||Downgrading the role of the heart from a vital
organ directly involved in personality, psyche and spirituality to
a mere pump had many implications. The investigation into the role
of the heart within the body took place during a period where
significant political and constitutional debates were taking
place. The de-mystification of the heart re-enforced challenges to
other received "truths" - such as Charles I's divine right to rule
England. Furthermore, Harvey provided ammunition to the new breed
of philosophers rejecting Aristotelian ideas. René Descartes
(1596-1650) quickly adopted and championed Harvey's idea of
circulation seeing it as a neat way of removing the soul from the
equation and so creating a purely mechanical explanation of the
Perhaps the most lasting influence, however, was brought about due to Harvey's scientific method. De motu cordis was often described as the very epitome of Baconian methodology. While commentators such as Walter Pagel have shown that Harvey was, in fact, very conservative, owing many of his circulatory ideas to traditional Aristotelian thought, De motu cordis quickly became understood as a rejection of traditional methods. It was viewed as challenging the traditional system of deductive reasoning via syllogisms, instead advocating experimentation and sensory experience. The empirical methodology observable in Harvey's work is now the acknowledged scientific method and has been universally adopted across all science and medicine.
|It is perhaps ironic that an Aristotelian traditionalist and
conservative produced a work that challenged all orthodox thinking
- a work which became synonymous with modernity and change.
William Harvey was born in Folkestone, Kent in 1578; he was
schooled at King's School Canterbury then Gonville and Cauius
College Cambridge. However, arguably it was his subsequent medical
schooling at Padua, and resultant exposure to the anatomical
research and methods of his Paduan predecessor Vesalius and his
teacher Fabricius, that was most instrumental in his medical
The University of Padua was a popular destination for many English medical students at the turn of the Seventeenth Century owing to its esteemed teaching staff and improved opportunity, in comparison with Oxford and Cambridge, for taking part in anatomical dissection. However, not all anatomy instruction at Padua followed the same approach. Vesalius had advocated a very novel empirical model urging students to become involved in dissection and "feel with [their] own hands and trust them". Conversely, Harvey's tutor Fabricius taught anatomy from an Aristotelian natural philosophical standpoint rather than a structural one - so advocated a less "hands-on" approach, discouraging direct participation. Consequently Harvey was educated in an environment where there was a tension between describing anatomy structurally, using an empirical approach, and teaching anatomy from a broader Aristotelian philosophical standpoint, explaining units of anatomy in isolation.
|Arguably this legacy of two alternative approaches can be seen in De motu cordis. While in practice, Harvey carried out experiments on the heart, taking measurements and "feel[ing] with his own hands" in the Vesalian tradition, he remained very deferential towards the ideas of Galen and particularly Aristotle throughout - even describing his enquiry as philosophical rather than medical.|
||Harvey's conservatism extended to his political opinions too.
In the debates that raged during the Seventeenth Century over
religious tolerance and the respective roles of parliament and
monarch in running the country, Harvey came down firmly on the
side of the king. In addition to his regular job as physician at
St. Bartholomew's Hospital, Harvey was employed as physician
extraordinary to both King James I and later his son Charles I.
During the First Civil War of 1642 Harvey even left London and
resided with the Royal court at Oxford.
His loyalty to the crown is evident in the wording of his dedication to Charles I in De motu cordis. In the dedication, Harvey likens the King's role in the state to that of the heart in the body, "the heart of all creatures is the foundation of their life, the Prince of all their parts . that on which all growth depends and from whence all strength and vigour flows. In like manner, the King is the foundation of his kingdom . the heart of his commonwealth, from whom all power flows and all mercy proceeds".
|De motu cordis, despite being
written by an Englishman and dedicated to the English King, was
first published in Frankfurt, Germany, a matter that has often
vexed commentators. Harvey was perfectly aware that the reactions
to his new discovery might not be favourable, declaring in his
prefatory dedication to De motu cordis,
addressed to the Royal College of Physicians, "Over many centuries
a countless succession of distinguished and learned men had
followed and illuminated a particular line of thought.. So I was
very much afraid of a charge of over presumptuousness should I
have let that book [De motu cordis]
. be published . unless I had first put my thesis before you...".
It has therefore been suggested that the work may have been
published in Germany in order to minimise provocation and outrage
|However, other commentators point out that Frankfurt was a
notable centre of learning during the first half of the
Seventeenth Century. The decision to publish in Frankfurt rather
than London may have made good sense academically: it would have
enhanced his reputation and highlighted his discoveries to the
Nonetheless, the Frankfurt based publisher, William Fitzer, being relatively unknown, was a strange choice for Harvey. A young Englishman living in Germany, Fitzer may have been chosen over other publishers after being recommended by Harvey's acquaintance and fellow physician, Robert Fludd (1574-1637). While it remains contested quite why Frankfurt and Fitzer were chosen by Harvey, opinion amongst commentators over the quality of Fitzer's work is of a consensus - poor. Most copies were produced on thin, poor quality paper with many errors in transcription from the manuscript. It has been suggested that the printers had great difficulty in deciphering Harvey's handwriting. A small number of copies contain an additional two leaf erratum listing 126 corrections to the original proof - probably added to only part of the edition after the earliest copies had been distributed.
|We are privileged to hold two copies of
De motu cordis in Glasgow University
Library, the featured copy (Sp Coll Hunterian Y.7.13) and another
copy lacking leaves A1-4 (Sp Coll Hunterian Ac.4.18).
Sadly neither copy contains the rare erratum; however, we are fortunate in that the featured copy is printed on
different paper from most of the initial print run - an excellent
quality paper with a different water mark.
Both copies of De motu cordis arrived in Glasgow in 1807 as part of the Hunterian Library. Dr Hunter (1718-83) was a famous anatomist and physician, and renowned collector of books, manuscripts, coins, medals, paintings, shells, minerals, and anatomical and natural history specimens. Under the terms of his will, his library and other collections remained in London for several years after his death - for the use of his nephew, Dr Matthew Baillie (1761-1823) - and arrived at the University in 1807.
|The featured copy, Sp Coll Hunterian Y.7.13, can be viewed in the Special Collections display case on Level 12 of the library from mid June until mid September. Other items from William Hunter's library, including works by Andreas Vesalius, can be viewed in the Hunterian Museum from May 23rd as part of the bicentenary celebrations of Hunter's bequest.|
Note on translation
All translations are from Gwyneth Whitteridge, 1976 apart from the translation of the epistle dedicatory in which Harvey relates his fear of being considered presumptuous and disrespectful of tradition: this translation is from Franklin, 1963, pp. 5-6.
Other items of interest
Selection of works referenced above and some other works written by Harvey in Special Collections:
The following were useful in compiling this article:
Robert MacLean June 2007